Trends of antibiotic use for acute upper respiratory infections in Chinese emergency departments and the impact of COVID-19: a cross-sectional study.

IF 4.8 2区 医学 Q1 INFECTIOUS DISEASES
Tingxi Wu, Tongxu Li, Heng Guo, Bin Zhu, Yang Zhang, Zhigang Zhao
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Abstract

Background: The emergence of Coronavirus Disease 2019 (COVID-19) has impacted antibiotic use; however, studies on antibiotic use for acute upper respiratory infections (AURIs) in Chinese emergency department (ED) settings are still scarce.

Objective: This study aimed to explore trends and patterns in antibiotic use and the impact of COVID-19 in Chinese ED settings.

Methods: A cross-sectional, retrospective analysis was conducted using prescriptions for ED visits due to AURIs through the Hospital Prescription Analysis Cooperative Project Database between 2018 and 2023. We examined patterns of antibiotic use for AURIs and employed an interrupted time series analysis to assess the impact of the COVID-19 pandemic on antibiotic use. The proportion of antibiotic prescriptions adhering to first-line guideline recommendations was also evaluated.

Results: A total of 1,972,270 prescriptions for AURIs from 108 hospitals in EDs were extracted. The antibiotic prescription rate (APR) was 58.44%. The predominant antibiotics prescribed for AURIs were second- and third-generation cephalosporins and azithromycin. Among these prescriptions, only 22.26% adhered to first-line guideline recommendations, while 83.82% involved Watch-group antibiotics. A substantial decrease in antibiotic consumption was observed at the onset of the pandemic, but no significant changes were found in the APR. After the relaxation of anti-COVID-19 measures, both antibiotic consumption and the APR exhibited an upward trend. However, neither returned to pre-pandemic levels.

Conclusion: Antibiotic use for AURIs was prevalent in ED settings, with a predominant use of broad-spectrum and Watch-group antibiotics. After the lifting of pandemic control measures, both antibiotic consumption and the APR exhibited an upward trend, underscoring the need to reinforce antimicrobial stewardship, particular targeting broad-spectrum and Watch-group antibiotic use.

中国急诊科急性上呼吸道感染抗生素使用趋势及COVID-19的影响:一项横断面研究
背景:2019冠状病毒病(COVID-19)的出现影响了抗生素的使用;然而,中国急诊科(ED)对急性上呼吸道感染(AURIs)抗生素使用的研究仍然很少。目的:本研究旨在探讨中国急诊科抗生素使用的趋势和模式以及COVID-19对急诊科的影响。方法:通过医院处方分析合作项目数据库,对2018 - 2023年因AURIs就诊的处方进行横断面、回顾性分析。我们检查了AURIs的抗生素使用模式,并采用中断时间序列分析来评估COVID-19大流行对抗生素使用的影响。我们还评估了遵守一线指南建议的抗生素处方比例。结果:共提取108家急诊科医院的AURIs处方1,972,270张。抗生素处方率为58.44%。AURIs的主要抗生素处方是第二代和第三代头孢菌素和阿奇霉素。其中,仅22.26%的处方遵循一线指南推荐,83.82%的处方使用了watch组抗生素。疫情发生时抗生素用量大幅下降,但抗菌素用量变化不明显。在疫情防控措施放松后,抗菌素用量和抗菌素用量均呈上升趋势。然而,两者都没有恢复到大流行前的水平。结论:急诊中AURIs的抗生素使用普遍,以广谱抗生素和watch组抗生素为主。在解除大流行控制措施后,抗生素消费量和APR均呈现上升趋势,这突出表明需要加强抗菌素管理,特别是针对广谱抗生素和观察组抗生素的使用。
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来源期刊
Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
9.70
自引率
3.60%
发文量
140
审稿时长
13 weeks
期刊介绍: Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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